Evidence-Based Decisions for Tube Feeding in Clients With Advanced Dementia
For people with advanced dementia who are permanently recumbent, aspiration is a serious risk. Aspiration and malnutrition are common in these patients. Percutaneous endoscopic gastrostomies are commonly used to reduce the risk of aspiration pneumonia and to provide “adequate nutrition and hydration.”
There are essentially no good randomized controlled trials of whether this intervention is effective for these indications. There is a priori little reason to believe that feeding via PEG-tube reduces the risks of aspiration pneumonia. The major adverse outcomes attributable to malnutrition are not improved in patients receiving tube feeding.
You will be able to:
- Outline for patients the main types of neurogenic dysphagia
- Review problems with the concept of “aspiration pneumonia”
- Define questions about the value of swallowing studies
- Review data about modifying the consistency of food and drink
- Suggest alternative strategies for people who aspirate
View the Table of Contents [PDF]
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